西非国家2009年与2019年居民健康预期寿命及死亡状况比较及对中非卫生合作的启示

Comparison of healthy life expectancy and mortality of residents in West African countries between 2009 and 2019 and its implications for China-Africa health cooperation

目的:比较西非国家2009年和2019年各国居民健康预期寿命及死亡状况,为后续规划与布局新时期的中非健康卫生合作,开展精准的援助项目提供数据支持。方法:基于2019年全球疾病负担研究(GBD 2019),收集和比较西非15个国家2009年和2019年健康预期寿命,传染病、母婴疾病和营养缺乏性疾病,慢性病及伤害的死亡变化情况。结果:与2009年相比,2019年西非15个国家的居民健康预期寿命有所增加,其中佛得角的居民健康预期寿命最高(64.6岁),几内亚比绍最低(53.6岁);2019年西非15个国家传染病、母婴疾病和营养缺乏性疾病的标化死亡率较2009年均显著下降;佛得角、布基纳法索和冈比亚的慢性病标化死亡率有所增加;布基纳法索和马里的伤害标化死亡率有所增加,尼日尔保持不变;其他国家的慢性病和伤害标化死亡率有所下降。与2009年相比,西非国家2019年传染病、母婴和营养缺乏性疾病死因占比均有所下降,但在多数国家的死因占比依然超过50%;其中,佛得角是唯一慢性病死因占比多于传染病、母婴和营养缺乏性疾病(72.2%vs.17.9%)的国家;2019年孕产妇疾病、麻疹和艾滋病等传染病死因顺位较2009年下降明显,而多种慢性病(如糖尿病、慢性肾脏疾病)的死因顺位有所上升。结论:在过去10年间,西非国家在国民健康状况方面取得了一些进步,但健康预期寿命仍相对偏低,面临着传染病和慢性非传染病双重威胁,而伤害死亡率也依然较高;中非健康卫生合作的援助内容和方式应根据受援国情况,因地制宜、精准施策。

Objective:To compare the healthy life expectancy(HALE),and mortality of residents in West African countries between 2009 and 2019,and to provide evidence support for subsequent planning,layout of a new era of China-African health cooperation and the implementation of precise assistance projects.Methods:Based on the Global Burden of Disease Study 2019(GBD 2019),this study collected and compared changes in HALE and mortality due to infectious diseases,maternal and neonatal diseases,nutritional deficiencies,chronic diseases,and injuries in 15 West African countries between 2009 and 2019.Results:Compared with 2009,the HALE in the 15 West African countries increased in 2019,with Cape Verde having the highest HALE(64.6 years)and Guinea-Bissau the lowest(53.6 years).In 2019,the standardized mortality rates for infectious diseases,maternal and neonatal diseases,and nutritional deficiencies in the 15 West African countries significantly decreased compared with 2009;the standardized mortality rates for chronic diseases increased in Cape Verde,Burkina Faso,and The Gambia;the injury standardized mortality rates increased in Burkina Faso and Mali,while remaining unchanged in Niger;the standardized mortality rates for chronic diseases and injuries decreased in other countries.Compared with 2009,the proportion of deaths due to infectious diseases,maternal and neonatal diseases,and nutritional deficiencies in West African countries decreased in 2019 but still exceeded 50%in most countries;among them,Cape Verde was the only country where the proportion of deaths from chronic diseases was higher than that from infectious diseases,maternal and neonatal diseases,and nutritional deficiencies(72.2%vs.17.9%).In 2019,the rank order of deaths due to maternal diseases,measles,and AIDS and other infectious diseases decreased significantly compared with 2009,while the rank order of deaths due to various chronic diseases(such as diabetes,chronic kidney diseases)increased.Conclusion:In the past decade,West African countries have made some progress in the health status of their citizens,but HALE remains relatively low,facing a dual threat of infectious and chronic non-communicable diseases,and the mortality rate from injuries remains high.China’s health assistance to these countries should be customized and implemented according to the specific needs of each recipient country.